Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/12—Ketones
  • A61K31/121—Ketones acyclic
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
  • A61K47/12—Carboxylic acids; Salts or anhydrides thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
  • A61K47/14—Esters of carboxylic acids, e.g. fatty acid monoglycerides, medium-chain triglycerides, parabens or PEG fatty acid esters
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
  • A61K47/34—Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/10—Dispersions; Emulsions
  • A61K9/107—Emulsions ; Emulsion preconcentrates; Micelles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/12—Drugs for disorders of the urinary system of the kidneys
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P19/00—Drugs for skeletal disorders
  • A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/02—Drugs for disorders of the nervous system for peripheral neuropathies
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
  • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• This invention relates to a pharmaceutical composition in the form of an emulsion, in particular an oil-in-water emulsion, comprising certain polyunsaturated long-chain ketones.
• the invention also relates to methods of treating or preventing certain inflammatory or proliferative conditions using the composition of the invention.
• the polyunsaturated long chain ketones which are described in these references have amphiphilic character but are primarily hydrophobic and therefore insoluble in water.
• the lack of water solubility limits the bioavailability of the compounds and limits the ability of the skilled person to administer a useful dose of these compounds to a patient.
• the lack of water solubility limits the ability of the skilled person to administer the compounds parenterally, e.g. intravenously, intramuscularly or subcutaneously to a patient.
• a further problem with the polyunsaturated ketone compounds of the invention is that they are susceptible to degradation. Any formulation of these compounds should also ensure that the compounds remain stable for a prolonged period.
• the present inventors sought a solution to the problem of parenteral administration of these compounds and the problem of their stability.
• the inventors have now found that these compounds can be advantageously formulated as an emulsion, in particular an oil-in-water emulsion. It is envisaged that the use of an emulsion may lead to a prolonged shelf life and should also allow administration of the compound of the invention by parenteral routes such as intravenously (i.v.), intramuscularly (i.m.) and sub-cutaneously (s.c.).
• composition in the form of an aqueous emulsion comprising:
• R is an unsubstituted linear C 10-24 unsaturated hydrocarbon group, said hydrocarbon group comprising at least 4 non-conjugated double bonds;
• L is a linking group forming a bridge of 2 to 5 atoms between the R group and the carbonyl CO wherein L comprises at least one of S, SO, SO 2 in the backbone of the linking group;
• composition in the form of an oil-in-water emulsion comprising:
• R is a linear C 10-24 unsaturated hydrocarbon group, said hydrocarbon group comprising at least 4 non-conjugated double bonds;
• L is a linking group forming a bridge of 2 to 5 atoms between the R group and the carbonyl CO wherein L comprises at least one of S, SO, SO 2 in the backbone of the linking group;
• composition in the form of an oil-in-water emulsion comprising:
• R is a linear C 10-24 unsaturated hydrocarbon group, said hydrocarbon group comprising at least 4 non-conjugated double bonds;
• L is a linking group forming a bridge of 2 to 5 atoms between the R group and the carbonyl CO wherein L comprises at least one of S, SO, SO 2 in the backbone of the linking group;
• the invention provides a method of treating or preventing an inflammatory or proliferative condition comprising administering to an animal, preferably a mammal, in need thereof, e.g. human, an effective amount of a composition as hereinbefore defined.
• the invention provides use of an emulsion as hereinbefore described in the manufacture of a medicament for use in the treatment or prevention of an inflammatory or proliferative condition in an animal.
• the invention provides a composition as hereinbefore described for use in the treatment or prevention of an inflammatory or proliferative condition in an animal.
• the invention provides an article of manufacture comprising a container carrying the composition as hereinbefore defined.
• compound of the invention relates to an active agent of formula (I), or a salt or solvate thereof, in particular a compound A or B as herein defined.
• oil-in-water formulation and “oil-in-water emulsion” are used interchangeably to describe a dispersion in an aqueous phase.
• the “dispersed phase” comprises the compound of the invention in an aqueous phase (the “continuous phase”).
• nanoemulsion relates to an oil-in-water emulsion in which the dispersed oil phase comprises “nanodroplets” which are hydrophobic droplets having a diameter of nanometers, i.e. from 1 to under 1000 nm, in a continuous aqueous phase.
• This invention concerns emulsions, especially oil-in-water emulsions, comprising compounds of formula (I) or salts thereof and their use in the treatment or prevention of various conditions such as inflammatory or proliferative conditions.
• the compound of the invention is preferably present in the dispersed phase of the oil-in-water emulsion.
• the emulsion comprises at least one compound of formula (I): R-L-CO—CF 3 (I)
• only one compound of formula (I) is present in the emulsions of the invention.
• the group R preferably comprises 5 to 9 double bonds, preferably 5 to 8 double bonds, e.g. 5 to 7 double bonds such as 5 or 6 double bonds. These bonds should be non-conjugated. It is also preferred if the double bonds do not conjugate with the carbonyl functionality.
• the double bonds present in the group R may be in the cis or trans configuration however, it is preferred if the majority of the double bonds present (i.e. at least 50%) are in the cis configuration. In further advantageous embodiments all the double bonds in the group R are in the cis configuration or all double bonds are in the cis configuration except the double bond nearest the carbonyl group which may be in the trans configuration.
• the group R may have between 10 and 24 carbon atoms, preferably 17 to 19 carbon atoms.
• the R group is unsubstituted.
• the R group is linear. It preferably derives from a natural source such as a long chain fatty acid or ester.
• the linking group L provides a bridging group of 2 to 5 backbone atoms, preferably 2 to 4 backbone atoms between the R group and the carbonyl.
• the atoms in the backbone of the linker may be carbon and heteroatoms but will include at least one of S, SO, or SO 2 .
• the linking group is preferably unsubstituted. It is preferably linear.
• Preferred components of the linking group are —CH 2 —, —S—, —SO—, and —SO 2 — which can be combined with each other in any (chemically meaningful) order to form the linking group.
• the linker —SCH 2 CH 2 — is formed.
• the linking group L contains at least one heteroatom in the backbone. It is also preferred if the first backbone atom of the linking group attached to the R group is a heteroatom or group of heteroatoms selected from —S—, —SO—, and —SO 2 .
• the linking group L contains at least one —CH 2 — link in the backbone. Ideally the atoms of the linking group adjacent the carbonyl are —CH 2 —.
• a heteroatom —S—, —SO— or —SO 2 is positioned ⁇ , ⁇ , ⁇ , or ⁇ to the carbonyl, preferably ⁇ or ⁇ to the carbonyl.
• linking groups therefore are —SCH 2 —, —SOCH 2 —, or —SO 2 CH 2 —
• Preferred compounds of formula (I) are those of formula (I′) R—Y1-CH 2 —CO—CF 3 (I′)
• Y1 is selected from S, SO or SO 2 .
• the compounds can be present in the emulsion as a salt or solvate. Preferably however, no such form is used.
• Compounds of formula (I) may be manufactured using known chemical synthetic routes found in J. Chem. Soc., Perkin Trans 1, 2000, 2271-2276 or J. Immunol., 1998, 161, 3421.
• emulsions of the compounds described herein can be formulated as an emulsion, such as an oil-in-water emulsion, preferably a nanoemulsion, when combined with a polysorbate or poloxamer surfactant and optionally a triglyceride excipient. It has surprisingly been found that emulsions of the compounds described have excellent long term storage stability, particularly at refrigerator or freezer temperatures.
• the compounds described have amphiphilic character but are primarily hydrophobic. It is thought that as a result of these characteristics, the compounds of the invention are capable of forming ordered nanostructures, such as micelles, in an aqueous environment. These micelles are not a structure which would usually be adopted by the compounds in pure form or in conventional solvents. The inventors have now established that particularly stable structures, such as mixed micelles, comprising both the compound of the invention and the triglyceride excipient have excellent storage stability.
• the amount of compound of the invention in the emulsion can vary. Suitable amounts include 1 to 500 mg, such as 1 to 300 mg, more preferably 1 to 250 mg, especially 1 to 150 mg, especially 1 to 100 mg per ml of emulsion. Values of 1 to 20 mg/ml, such as 1 to 10 mg/ml are especially preferred.
• the emulsions of the invention include a polysorbate and/or poloxamer surfactant.
• Appropriate levels of surfactant are 0.1 to 100 mg, such as 0.1 to 25 mg of surfactant in 1 mL of emulsion, preferably 0.2 to 20 mg, such as 0.5 to 15 mg, and especially 1 to 12 mg per mL of emulsion.
• Polysorbate surfactants are based on sorbitan, which is a sugar derivative having four OH groups per molecule. Suitable surfactants are those in which the OH groups of sorbitan are capped with repeating ethoxy groups and one of the repeating ethoxy groups is itself capped with a fatty acid ester.
• Polysorbates such as polysorbate 20, 40, 60 or 80 could be used.
• a particularly preferred surfactant is Polysorbate 80.
• the surfactant may be a poloxamer.
• polyxamer is a term of the art and describes block polymers having a central block of polyoxypropylene and two outer blocks of polyoxyethylene.
• a particularly preferred poloxamer is Poloxamer 188.
• polyethoxylated non-ionic surfactants are suitable herein.
• surfactants such as two or more polysorbates, two or more poloxamers or a poloxamer and a polysorbate.
• one surfactant is used.
• the active compound is compound A or B defined above and the surfactant is a polysorbate, especially polysorbate 80.
• compositions of the invention can comprise one or more triglycerides, preferably one triglyceride.
• the triglyceride component ideally acts to dissolve the compound of the invention to encourage formation of micelles in an aqueous environment in the presence of the surfactant.
• the triglyceride forms a minor component, it can be seen assisting in the formation of micelles and/or improving the stability of micelles formed by the compound of the invention.
• the excipient forms a major component (i.e. is present in a greater amount percentage by weight than the compound) it can be seen as a type of carrier for the compound.
• the triglyceride is preferably a medium chain triglyceride (MCT), which are compounds having a glycerol backbone esterified with three C6-C12 fatty acids, especially caproic acid (C6:0), caprylic acid (C8:0), capric acid (C10:0) or lauric acid (C12:0).
• MCT medium chain triglyceride
• Suitable sources include corn oil, sunflower oil, peanut oil, olive oil, coconut oil, or most preferably MCT oil, which is a highly purified coconut oil.
• Suitable levels of excipient are 0.1 to 500 mg, such as 0.1 to 25 mg of triglyceride in 1 mL of emulsion, preferably 0.2 to 20 mg, such as 0.5 to 15 mg, and especially 1 to 12 mg per mL of emulsion. Where mixtures of triglycerides are used as the excipient, these levels relate to the mixture of triglycerides.
• the compound is compound A or B as herein defined and the triglyceride is MCT oil.
• the compound is A or B, the triglyceride is MCT oil, and the surfactant is Polysorbate 80.
• the balance of the emulsion is the buffer and/or chelating agent (and water).
• the emulsion of the invention includes a buffer, a lipid soluble antioxidant and/or chelating agent.
• the emulsion of the invention comprises a buffer and/or a chelating agent.
• the emulsion contains a buffer.
• any buffer present will maintain the pH of the emulsion at around 7.
• the buffer maintains the pH of the emulsion in the range of 6 to 9, preferably 6 to 8, more preferably pH 7 ⁇ 0.5.
• Any suitable buffer may be used.
• a particularly preferred buffer is citrate buffer.
• the emulsion is isotonic.
• the molarity of the buffer may be 5 to 20 mmol, such as 10 mmol.
• Certain buffers such as citrate buffer may also bind traces of metals and thereby reduce oxidative degradation of the compound of the invention.
• a separate chelating agent e.g. EDTA or a salt thereof, may also be present.
• compositions may also comprise a lipid dissolvable antioxidant such as tocopherol or other vitamin E analogue.
• a lipid dissolvable antioxidant such as tocopherol or other vitamin E analogue.
• the emulsions of the invention may also contain other active components, e.g. other drugs, although this is not preferred.
• the emulsion consists of the compound of the invention, the polysorbate or poloxamer surfactant, the triglyceride excipient and a buffer and/or chelating agent (along with water).
• the invention provides a pharmaceutical composition in the form of an aqueous emulsion comprising from about 1 mg to about 500 mg of a compound of formula A or B
• a buffering agent e.g. a citrate buffer.
• the emulsion of the invention is a nanoemulsion.
• the nanoemulsion comprises a dispersed oil phase and a continuous aqueous phase.
• the particles of the dispersed phase have an average particle size of from 1 to less than 1000 nm, preferably 5 to 200 nm. Particle size can be measured by routine means, e.g. by microscopy (TEM, SEM, AFM), light scattering techniques (Photon Correlation Spectroscopy (PCS)), etc.
• the emulsions of the invention are generally formed by mixing the components (compound, surfactant, excipient and any additives) and making the volume up a predetermined level using water for injection (WFI). It may be that the compound of the invention is precontacted with the triglyceride before addition of the surfactant.
• WFI water for injection
• the water will typically be added containing the buffer/chelating agent.
• the mixture of components can then be agitated, e.g. using a shaker and/or with sonication.
• the emulsion may be sterile filtered after production.
• compositions of the invention can decompose into a variety of by-products.
• by-products are sulfoxide and thiol compounds derived from the compound of the invention.
• the generation of by-products can be reduced by formulation of the compounds as an emulsion as described herein.
• emulsions comprising a surfactant and an excipient of the invention have excellent long term storage stability.
• stable it is meant that the compound peak area, as measured by chromatograph, is reduced by no more than 20% after 1 month of storage at 5° C., and preferably no more than 20% reduction after 3 months of storage at 5° C., preferably no more than 20% reduction after 6 months of storage at 5° C. in an inert atmosphere.
• the peak area is reduced by no more than 10% after 1 month, 3 months or 6 months of storage at 5° C. Most preferably the peak area is reduced by no more than 5% after 1 month, 3 months or 6 months of storage at 5° C. in an inert atmosphere.
• the compound peak area is reduced by no more than 5% after 1 month of storage at ⁇ 20° C., and preferably no more than 5% reduction after 3 months of storage at ⁇ 20° C., preferably after 6 months of storage at ⁇ 20° C. in an inert atmosphere.
• the peak area is reduced by no more than 3% after 1 month, 3 months or 6 months of storage at ⁇ 20° C. in an inert atmosphere.
• the peak area is reduced by no more than 2% after 1 month, 3 months or 6 months of storage at ⁇ 20° C. in an inert atmosphere.
• compositions of the invention are suitable for administration to a patient.
• the composition may be provided in a container holding the emulsion.
• the container may form part of a kit along with instructions for administration of the composition.
• the administration route is parenteral such as subcutaneous, intramuscular or intravenous
• the container may be an administration device comprising a pre-determined amount of the formulation, e.g. a pre-filled syringe.
• the container preferably comprises an inert gas added to displace air and hence maximise storage stability.
• Suitable containers may have a volume up to 10 ml, such as 1 to 10 ml.
• the emulsions of the invention are proposed for use in the treatment or prevention of inflammatory disorders or proliferative conditions including psoriasis, glomerulonephritis, lupus nephritis, diabetic nephropathy, rheumatoid arthritis, dermatitis and cancers such as skin cancer.
• the emulsions of the invention are proposed for use in the treatment or prevention of inflammatory disorders or proliferative conditions including diabetic nephropathy and arthritis such as rheumatoid arthritis.
• treating or treatment is meant at least one of:
• prevention means (i) preventing or delaying the appearance of clinical symptoms of the disease developing in a mammal
• composition of the invention are used therapeutically, i.e. to treat a condition which has manifested rather than prophylactically. It may be that the composition of the invention is more effective when used therapeutically than prophylactically.
• composition of the invention can be used on any animal subject, in particular a mammal and more particularly to a human or an animal serving as a model for a disease (e.g., mouse, monkey, etc.).
• a mammal in particular a mammal and more particularly to a human or an animal serving as a model for a disease (e.g., mouse, monkey, etc.).
• a “therapeutically effective amount” means the amount of a composition that, when administered to an animal for treating a state, disorder or condition, is sufficient to effect such treatment.
• the “therapeutically effective amount” will vary depending on the composition, the disease and its severity and the age, weight, physical condition and responsiveness of the subject to be treated and will be ultimately at the discretion of the attendant doctor.
• composition of the invention has to be readministered at certain intervals. Suitable dosage regimes can be prescribed by a physician.
• composition for use in accordance with the present invention is ideally in a form for parenteral administered, e.g. as an emulsion for injection.
• Therapeutic doses will generally be between about 10 and 2000 mg/day and preferably between about 30 and 1500 mg/day. Other ranges may be used, including, for example, 50-500 mg/day, 50-300 mg/day, 100-200 mg/day.
• Administration may be once a day, twice a day, or more often, and may be decreased during a maintenance phase of the disease or disorder, e.g. once every second or third day instead of every day or twice a day.
• the dose and the administration frequency will depend on the clinical signs, which confirm maintenance of the remission phase, with the reduction or absence of at least one or more preferably more than one clinical signs of the acute phase known to the person skilled in the art.
• Compound B is solubilized in 10 mM sodium citrate (pH 7) by use of MCT oil 2 mg/ml and Polysorbate 80, 2 mg/ml; the samples have been saturated with argon as part of the filling process, and are filled in 10 ml freeze-stable polymer-vials.
• Components 2 mg
• Compound B/ml nano-emulsion MCT oil 2 mg/ml and P80 2 mg/ml and Citrate buffer 10 mM
• Components 1 and 2 are mixed at ambient temperature in a vessel and flushed with argon.
• Component 3 is added with mixing.
• the blend is heated to 80-85° C. in a water bath.
• Component 4 is added at 60-80° C. slowly with frequent mixing/vortexing.
• the product was sterilized by filtration, purged with argon and filled into 10 ml vials. Vials are flushed with argon before closure. Vials were frozen at ⁇ 20° C.
• the method used is a RP HPLC method using UV detection.
• the conditions are summarised below:
• Collagen induced arthritis is a commonly used arthritis model in preclinical research.
• the disease is induced by injecting type II collagen (a cartilage component) emulsified in complete Freund's adjuvant in the high responder DBA/1 mouse strain (or in other species such as the rat or the monkey).
• type II collagen a cartilage component
• DBA/1 mouse strain or in other species such as the rat or the monkey.
• Introduction of collagen breaks tolerance and directs an immune-mediated inflammatory attack on the joints that can be measured by evaluating standard disease parameters as based on an arthritis index score: (Animal models for arthritis: innovative tools for prevention and treatment, Ann Rheum Dis. 2011 August; 70 (8): 1357-62).
• Compound B was formulated for subcutaneous administration in a nano-emulsion containing 2 mg/ml Compound B, 2 mg/ml MCT oil (Lipoid), 2 mg/ml Polysorbate 80 (Fluka) and sodium citrate buffer 10 mM (pH 7).
• the final solution was sterilized by filtration and saturated with Argon 5.0 AGA prior to aliquoting in 10 ml tubes stored at ⁇ 20° C. till further use.
• mice 7-10 weeks old male DBA/1 mice were sourced from Beijing Vital River laboratories, China (average weight at the beginning of the study: 18-25 g). The animals were housed in an animal room set at a temperature of 23 ⁇ 2° C., humidity of 40-70%, under a 12-hour light/12-hour dark cycle. SPF (Serum Pathogen Free) mouse growth breeding feed (Beijing KeaoXieli feed Co. LTD) was provided ad libitum throughout the in-life portion of the study. Water was available ad libitum.
• CIA was induced in male DBA/1 mice (except sham group) by immunization with 0.1 ml emulsion containing an equal volume of bovine type II collagen solution (2 mg/me and Freund's complete adjuvant (FCA) at the tail base.
• FCA Freund's complete adjuvant
• CIA was assessed in mice by two blinded observers to measure paw swelling with a capacity measurement method.
• the occurrence of arthritis was observed by scoring all four paws for severity of erythema and swelling, using a clinical score ranging from 0 (no swelling) to 4 (severe swelling and erythema) as below, yielding a maximum Arthritis Index (AI) score of 16 (4 paws ⁇ max score per paw): J Med Chem. 2014 Sep. 25; 57 (18):7523-35, Kokotos et al.
• AI Arthritis Index
• the detailed dosing info per treatment group was as follows.
• Group 1 7 mice that have received no collagen, treated with vehicle DMSO (everyday) for 3 weeks.
• Group 2 11 mice were induced by collagen and treated with vehicle DMSO (everyday) for 3 weeks.
• Group 3 11 mice were induced by collagen and treated with Compound B (5 mg/kg, Daily) for 3 weeks.
• Group 4 11 mice were induced by collagen and treated with Compound B (10 mg/kg, Daily) for 3 weeks.
• mice were euthanized according to applicable ethical laws by carbon dioxide inhalation.
• a 100% incidence of CIA was observed by day 32 in CII-immunized mice, with a maximum AI of 4.18 observed at Day 43 post immunization.
• the AI and incidence of all groups increased in a time-dependent mode from day 27 to day 43.
• the AI of Compound B 10 mg/kg group on Day 41 ⁇ 43 was significantly reduced (p ⁇ 0.05) in comparison to the CIA control group.
• the AI index of Compound B 5 mg/kg group was also reduced when compared with that of the CIA control group, however, the reduction reached no statistical significance (p>0.05) (Table 8).
• the STZ diabetic nephropathy model is frequently used in preclinical diabetic & kidney research as it recapitulates several features of the human disease.
• streptozotocin STZ
• STZ streptozotocin
• rats or mice
• STZ streptozotocin
• disease progression in this model can be monitored by analysing increasing levels of various biochemical (urine protein, albumin, protein to creatinine rations etc) or histological markers (a-SMA, Fibronectin etc) allowing direct assessment of action of chronically administered agents, Tesch, Nephrology (Carlton). 2007 June; 12 (3):261-6.
• biochemical urine protein, albumin, protein to creatinine rations etc
• histological markers a-SMA, Fibronectin etc
• Compound B was formulated for subcutaneous administration in a nano-emulsion containing 2 mg/ml Compound B, 2 mg/ml MCT oil (Lipoid), 2 mg/ml Polysorbate 80 (Fluka) and sodium citrate buffer 10 mM (pH 7).
• the final solution was sterilized by filtration and saturated with Argon 5.0 AGA prior to aliquoting in 10 ml tubes stored at ⁇ 20° C. till further use.
• a separate Polysorbate 80- and sodium citrate buffer-based vehicle solution without Compound B and MCT oil was also prepared, sterilized, aliquoted and stored, serving as the subcutaneous vehicle control used in the STZ animal study.
• Urine protein Bradford assay kit: Quick Start ⁇ Bradford dye reagent and BSA standard set. Catalog #500-0205 (Bio-Rad Laboratories, Inc. Hercules, Calif., USA). Quick Start is a colorimetric assay based on the reaction of proteins with an alkaline copper tartrate solution and Folin reagent.
• Urine Albumin Nephrat II Quantitative Determination of Rat Urinary Albumin Kit. Catalog #NR002 Strip Plate (Exocell Inc., Philadelphia, Pa., USA). Nephrat II is a direct competitive ELISA for the quantitative determination of urinary albumin in rat specimens. An anti-rat albumin antibody-HRP conjugate is allowed to react with standards and diluted urine samples. A chromogenic substrate, TMB, is added to the wells, and color development ensues. Color intensity is inversely proportional to the log of rat albumin concentration of the sample.
• Urine creatinine The Creatinine Companion Assay Kit. Catalog #1012 (Exocell, Inc., Philadelphia, Pa., USA) was used to measure urine creatinine.
• the procedure is an adaptation of the alkaline picrate method and entails determination of the differential absorbance in a sample before and after the additions of acid to correct for color generation due to interfering substances.
• Assay instrument Bio-Rad iMark microplate reader.
• HRP Peroxidase
• Histopathological analysis was conducted using an Olympus BX51 research microscope equipped with a DP-71 digital camera. Image-Pro Plus software was used for computer-assisted image analysis.
• DN was induced in rats (except sham group—Group 1) by tail vein injection of streptozotocin (STZ) (S0130, Sigma Aldrich Corporation, St. Louis, Mo. USA) at a dose of 50 mg/kg in 0.4-0.45 ml of citrate buffer. Sham control received a similar injection in citrate buffer in the absence of STZ. The injection was given on Day 0. Treatment started on Day 3 and continued for up to 6 weeks.
• STZ streptozotocin
• Table 9 above summarizes the treatment schedules of the study. Overall, 3 different doses (2, 4 and 6 mg/kg) of Compound B were administered subcutaneously (SC) for 6 weeks following induction of diabetes. Vehicle control was administered in Group 1 (animals that did not receive STZ) and Group 2 (animals that have received STZ), daily for 6 weeks. Periodical collection of urine and blood was performed to allow multiple biochemical analyses as described below.
• Clinical signs All clinical signs were recorded for individual animals, once before commencement of treatment and once daily during the study. Observation was performed at the same time interval each day.
• Body weight Each animal was weighed on the day of allocation to its corresponding group and then every time prior to injection of each test article for dose volume adjustments.
• Blood glucose was measured at the 0, 1, 2, 4, and 6 week time points by collecting a drop of blood from freshly pierced tip of the tail using a sterile 25 G needle. Blood glucose measurements were conducted immediately by direct test strip analysis.
• Urine Protein At the 0, 2, 3, 4, 5 and 6 week time points the rats were set up in metabolic cages for urine collection. Measurements of urine protein were performed on 12 hour void volumes ranging from 7-16 ml. All 12 hour urine protein values (expressed in mg) were extrapolated to 24 hours to correspond to standard practice in the field.
• Urine Albumin Measurements of urine albumin were performed on samples collected at the 0 and 6 week time points. As with urine protein data the albumin values were extrapolated to 24 hours to correspond to standard practice in the field.
• Urine Creatinine Measurements of urine creatinine were performed on samples collected at the 0 and 6 week time points. The urine creatinine data was used to determine protein and albumin ratios and expressed as milligram Creatinine: gram protein or albumin (mg/g) to correspond to standard practice in the field.
• Euthanasia Animals that have completed the scheduled test period were disposed with carbon dioxide according to standard ethical guidelines. All animals were subjected to necropsy, supervised by a pathologist, as detailed below. The scores of sacrificed animals were included in the calculations of the mean group scores throughout the experiment and until its end.
• Necropsy On the completion day, sacrifices were performed at approximately 5 hours after the last application. A macroscopic examination of the animal was performed on all sacrificed animals and any abnormality was recorded.
• Kidney tissue collection Immediately after the blood collection, the left and right kidneys were excised, cut in 3-4 mm thick coronal slices. A central slice of kidney was placed in formalin for subsequent embedment and routine histological assessments. Several slices were placed on aluminum foil strips and flash frozen by immersion in liquid nitrogen and placed in air-tight storage vials for subsequent immunohistochemical assessment. All samples were frozen at ⁇ 80° C. until analyzed. The following analyses were performed:
• Glomerular ⁇ -SMA staining (for area of glomerular mesangial activation): Frozen kidney sections were cut and batch stained for ⁇ -SMA using a monoclonal primary antibody (Clone 1A4, Sigma Chemical Co, St Louis, Mo.) using standard immunohistochemical methods. Peroxidase-conjugated second antibody was detected utilizing ImmPress polymer detection reagents according to the manufacturer's instructions (Vector Laboratories, Inc. Burlingame, Calif.). Group 3 (STZ+Compound B [2 mg/kg] sc) was omitted from the analysis.
• Glomerular fibronectin staining (for area of glomerular matrix): Frozen kidney sections were cut and batch stained for fibronectin staining using a monoclonal primary antibody (Clone IST-9) AbCam (Cambridge, Mass.) and standard immunohistochemical methods conducted at Probetex (See attached SOP). Group 3 (STZ+Compound B [2 mg/kg] sc) was omitted from the analysis.
• ⁇ -SMA (area of mesangial cell activation): Glomerular ⁇ -SMA staining was assessed by image analysis. Digital images were taken of twenty-five random glomeruli at an objective magnification of 10 ⁇ . Total area of glomerular staining was measured by computer assisted image analysis using the tracing tool of Image-Pro imaging software to capture glomerular area. The images were segmented and converted to gray scale then pseudo-colored representing background (blue) and positive staining (red) areas and percent area representing ⁇ -SMA positive mesangial cells was quantitated. Data were saved on an excel spreadsheets and average staining area was calculated and analyzed statistically.
• Fibronectin (area of mesangial cell matrix accumulation): Image analysis of glomerular staining for fibronectin was conducted using the same methods discussed above for ⁇ -SMA.
• Blood glucose Average blood glucose at start of the study was 127 mg/dl (range 120-131 mg/dl). All rats receiving STZ became diabetic (blood glucose >200 mg/dl) at the start of the experiment, except for rats #11 (Group 2), 21, 31 and 32 (Group 4), and 41 (Group 5). Of these rats, only #11 progressed to values greater than 200 mg/dl for the remainder of the study. Most remaining rats developed hyperglycemia by the 2 week time point. However, despite elevated glucose readings at the start of the 2 week period, some of the rats (distributed among the groups) did not sustain their diabetic status. All remaining animals at 4 and 6 weeks had glucose values above 200 mg/dl. The sensitivity of the meter measures a maximum of 500 mg/dl, thus some of these values may be under estimates. Average blood glucose levels for each group are illustrated in the summary table below.
• Urine Protein Average pretrial urine protein values ranged from 0.7 to 3.7 mg/dl among the groups.
• STZ controls (Group 2), showed an initial spike in proteinuria at 2 weeks with 43.5 mg/24 hrs. These values lessened thereafter, but remained elevated at 27.2, 33.9, 30.2 and 34.2 mg/24 hours at 3, 4, 5, and 6 weeks, respectively.
• Proteinuria in vehicle controls (Group 1) ranged from 17.0-24.6 mg/24 hours throughout the course of the study.
• Compound B treatment resulted in a reduction in proteinuria relative to STZ+vehicle as indicated in Table 11 below.
• Urine protein-to-creatinine ratios provide more accurate estimates of the urinary protein excretion rate and are not affected by hydration. Thus, urine protein to urine creatinine ratios were determined at 0 and 6 week time points. The results showed similar trends as protein measurements alone, however differences among the groups were more defined. For example, STZ+vehicle showed a 70% increase in UP/CR (1715: 2919) relative to citrate control at the 6 week time point. All treatment groups (except low-dose Compound B) had ratios less than STZ+vehicle; reductions followed a dose-dependent pattern.
• Urine Albumin Urine albuminuria is a more sensitive measurement of glomerular permeability defects than urine protein, particularly in diabetic nephropathy. As with urine protein-to-creatinine, albumin-to-creatinine ratios provide more accurate estimates of the urinary albumin excretion rate, and are not affected by hydration. Thus, urine albumin and urine albumin:creatinine ratios were measured at 0 and 6 week time points. The results showed similar trends observed for urine protein data where baseline average pretrial urine albumin:creatinine ratios ranged from 128 to 387 among the groups. Albumin:creatinine ratio in citrate controls (Group 1) averaged 457 at 6 weeks of diabetes.
• Urine Albumin & Urine Albumin/Creatinine Ratio mg/24 hr UA/CR mg/g Group 0 wk 6 wks 0 wk 6 wks
• G1 Critrate (iv) + Vehicle, (sc, daily) 1.3 5.6 247.2 456.6
• G3 STZ + Compound B [2 mg/kg] 0.8 18.8 128.5 1492.4 sc, daily
• G4 STZ + Compound B [4 mg/kg] 0.8 10.9 127.8 942.9 sc
• Sham-vehicle (Group 1) rats progressively gained weight as expected. Growth of all animals treated with STZ was stunted relative to sham based on average body weight measurements for each group. The health of the animals throughout the course of the study appeared very good and there were no toxicities or mortality observed for Compound B treated groups.
• Basal glomerular mesangial cell a-SMA staining is enhanced upon activation in a number of renal diseases including diabetic nephropathy Sham controls (Group 1) had the least mesangial a-SMA where average areas of staining were 2.1% of the glomerular area.
• Vehicle-treated STZ controls (Group 2) showed the highest level of mesangial ⁇ -SMA staining reaching 4.6% of the glomerular area.
• Treatment with Compound B blunted STZ related mesangial cell activation and a-SMA staining in all treatment groups was less than STZ-vehicle controls (Table 13).
• Glomerular fibronectin staining used as an index of matrix accumulation, showed similar trends as observed for a-SMA. As with a-SMA, glomerular mesangial Fn staining is enhanced upon activation in renal disease including diabetic nephropathy. Basal Fn expression in sham controls (Group 1) averaged 18.2% of the glomerular area. Vehicle-treated STZ controls (Group 2) showed high levels of mesangial Fn staining reaching 22.8% of the glomerular area. Treatment with Compound B resulted in a significant reduction in Fn expression relative to vehicle controls (Table 14).
• Compound B administered in a subcutaneous formulation, was effective in reducing proteinuria, albuminuria, urine protein:creatinine and urine albumin:creatinine ratios in this model (especially at the high dose).
• Compound B reduced glomerular expression of glomerular ⁇ -SMA and Fn-protein expression assessed by immunohistochemical evaluation. Overall, Compound B did not induce side effects during a 6-week course of treatment.

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